Physiotherapeutic Management in Breast Cancer Patients

Abstract

Breast cancer treatment can lead to various physic and psychic long-term morbidities, such as restricted shoulder joint range of motion, lymphedema, impaired muscle strength, or cancer-related fatigue. Physiotherapy is a body-oriented approach to tackle these different complaints. This chapter starts with possible prehabilitation approaches until therapy or surgery. It continues with early post-op mobilization and shoulder-arm exercises during the early stages and additionally breathing exercises. In the following rehabilitation period and after hospital discharge, the focus lies on shoulder joint range of motion, muscle strengthening, and body posture to regain normal activities of daily life. This is supported by easy learnable exercises and therapy measures. Lymphedema prevention and treatment are discussed as well as sports therapy, which is divided into endurance and strength training. Therefore, an active lifestyle is encouraged by also considering necessary precautions while training during chemotherapy cycles. Common symptoms and problems, such as cancer-related fatigue and chemotherapy-induced polyneuropathy, are tackled with techniques, such as yoga or balance training. Scar therapy and radiation-induced lung injury are delineated followed by massage therapy proposals and specified exercises to enhance oxygen uptake.

Supportive Exercises For Cancer Patients

“…For fatigued patients, brisk walking, stationary cycling, or treadmill exercises, along with other exercises, is recommended for at least 30-60 minutes per week. Patients can start their exercise routine with a low intensity, such as 5 minutes per week, and gradually increase up to 30 minutes over the course of a week or month [18]. Walking at a moderate intensity (50-70% of maximum heart rate) during chemotherapy and radiation therapy for breast cancer, starting from 10 to 45 minutes daily, for 4-6 days per week over 6 months, has been shown to reduce CRF and improve quality of life in non-cachectic patients [19].…”

“…Each of these positions was practiced for up to 7-10 minutes for an eight-week program [18]. Yoga is considered a low-intensity mind-body exercise (BMT).…”